Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 5015372 | NC |
N | 363LA2200X | Nurse Practitioner - Adult Health | 5015372 | NC |
N | 363LF0000X | Nurse Practitioner - Family Medicine | AP09060 | LA |
N | 363LG0600X | Nurse Practitioner - Gerontology | 5015372 | NC |
N | 363LG0600X | Nurse Practitioner - Gerontology | AP09060 | LA |
NPI | 1043762719 |
---|---|
Provider Name | Ashley Michelle Wiltcher |
First Address | Albermarle, NC 28801-3350 |
Second Address | Albermarle, NC 28801-3350 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2016 |
Last Update Date | 03/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2432761 | (05) | LA |
546776YJBU | (02) | LA |